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Learn life-changing information about the prevalence of childhood obesity, and actionable steps that you can take to insure that the children in your life grow up happy and healthy.

Why Johnny Can’t Lose Weight

Ten-year-old Johnny is too heavy. He hates to exercise. He prefers to surf the Internet, watch TV or play Nintendo rather than run and romp outdoors. During the rare gym class at school, when he is forced to play softball, Johnny spends a little time trying to catch the ball and throw it to another player, but he's not good at it and quickly loses interest. Johnny is nearly the last one picked to be on a team, reinforcing his dislike of exercise. After school, he feels depressed. While watching TV, he polishes off a giant bag of potato chips and a Coke.

Johnny represents a sad scenario that has been repeated too often in recent times. Over the past 20 years, the rates of obesity have taken a dramatic upswing. Today, 27 percent of children are classified as obese (carrying an excess accumulation of body fat), representing a 54 percent increase in the last two decades. What has caused such an alarming jump in childhood obesity? Can this trend be reversed?

Could Johnny's weight problem be caused by a medical condition? Probably not. This is rare, occurring in only one to 10 percent of cases of childhood obesity. Is it genetic? Yes, much of it is. Various factors, such as basal metabolic rate--the level at which energy is expended while resting--are passed from parent to child. Also inherited are the rate at which food intake increases metabolism, appetite control, what it takes to feel satisfied, and the metabolism and storage of fat.

Recognizing that genetic factors play a significant role in the development of obesity can dispel some of the guilt, depression and low self-esteem Johnny feels. However, human genetic makeup has not changed in the past 20 years, so that can't be the primary cause of the epidemic of childhood obesity. Rather, it is a lifestyle that combines an increasing tendency toward sedentary activity with a diet laden with fat and calories.

In the United States, people spend more time watching television than any other activity except working and sleeping. Children ages 6-11 spend an average of 3.5 hours a day watching television. Obviously, when Johnny lies around watching TV, playing video games or using his computer instead of playing vigorously, his body does not burn enough calories. To make matters worse, while Johnny engages in these activities, he is often snacking, predominantly on high-calorie food.

Johnny has fewer opportunities for physical activity. Budgetary constraints have caused many schools to reduce or eliminate physical education. Since schools place little importance on physical activity, more and more young Johnnys are being created.

The decrease in physical activity is not entirely due to a lack of formal exercise like sports. Johnny also experiences less physical exertion in his daily living. These days, people drive everywhere. A generation or two ago, they walked. Today's kids don't shovel snow, rake leaves, chop wood or push mowers across lawns. Instead, they use snow and leaf blowers, chain saws and riding mowers. The bottom line is that children--and adults--have to make efforts to be more physically active because it is not happening in the day-to-day experience of their lives.

Johnny can't lose weight unless he changes his lifestyle. He must increase physical activity and decrease the time spent on TV, video games and computer usage.

Dietary habits have changed considerably over the past 20 years. Currently, three-quarters of all meals are eaten outside the home, with the majority being eaten at restaurants.

The increasing reliance on restaurant and fast foods increases obesity in several ways. First, in order to make the foods taste better, restaurant chefs add high amounts of sodium and fat. Second, portion sizes are considerably larger at a restaurant-- probably to justify the meal’s cost. After dining out so frequently, families increase their portion sizes at home to make those servings more consistent with the restaurant meals.

Third, we succumb to the great bargain of "supersizing" our soda and fries for a few pennies more. Most people by nature are "completers": if we are given a larger portion, we will finish it; the food is right there in front of us and paid for.

Family dynamics have also changed. Less time is available for preparing homemade foods, increasing the reliance on restaurant and "zap and eat" meals. Fewer families eat together, and busy schedules force family members to "fend for themselves." When Johnny grabs something quick and convenient, it is typically some processed food high in sugar and fat.

Busy parents need practical advice on how to decrease the likelihood of obesity in their children while living modern lives. First, limit television watching. The same goes for video games and computers. Parents can set an "allowance" of a certain number of minutes per day or per week so children plan their TV viewing and computer activities as an event and not as a substitute for physical play.

Second, add more physical activity as a family. Suggestions include bicycle riding, playing Frisbee or catch in the yard, hide and seek and tag with a lot of running. You might even try vigorous dancing to loud and fun music as a family. Activities like washing the car and house-cleaning can be creatively developed to accomplish needed tasks and provide exercise at the same time. If it is impossible for the parents to participate in these activities, engage a teenage baby-sitter or playmate whose responsibility would be playing actively with their kids several days a week. What a healthy investment this would be!

Of utmost importance in the prevention and treatment of obesity is a commitment to involve the entire family in better nutritional habits. The family does not have to always be on a diet, but a conscious effort to eliminate empty calories from the family's diet is important.

Changing your family’s most common beverage offers an easy way to get rid of empty calories. Soda, which possesses no nutritive value, only empty calories, should not be a staple of the diet but allowed only on limited occasions. Replace it with water as the beverage of the household.

Children below the age of two need to drink whole milk for important brain development. However, after two, children should be on skim milk. Skim--fat free--milk has no grams of fat but contains all the protein, carbohydrate and calcium of whole milk.

Johnny also needs to limit the amounts of juices and fruit-flavored drinks, which often contain many teaspoons of added sugar. Pure juice products are better because they contain more nutrients, but the volume of juice still needs to be limited. If Johnny eats fruits instead of drinking juice, he’ll get fiber, which is important in digestion and the satisfaction of hunger.

Parents can take advantage of their children's natural appetites to introduce healthier eating habits. Most Johnnys are ravenously hungry between 3-4 p.m. after school. This is an excellent opportunity for children to eat fruits and vegetables: grapes, apple or pear segments or cut-up carrots, bell peppers or celery along with a low fat dip. The same vegetables presented with dinner may be given little attention by the child who prefers the other--higher calorie--foods served at the meal. Buy precleaned baby carrots for their ease of preparation--none--and cut up fruit snacks the evening before.

Parents can take advantage of frozen vegetables, a great modern convenience. A frozen vegetable medley or broccoli bits have as many nutrients and almost as much taste as the fresh variety. Their quick addition to a fast meal like chicken breast--or even pizza--improves nutritional values without piling on the calories.

Serving foods "family style" encourages taking "seconds" of favorite foods. Instead, fill the plates from the stove. This is especially important with desserts, which should never be accessible on the table.

Candy and treats do not have to be banished forever, but do avoid the two- to three-pound bags of M&Ms. Single-serving size treats and candies are savored and enjoyed more slowly because Johnny knows that once they are gone, he won’t get any more!

Finally, parents need to expose Johnny to a variety of different foods. Yes, some children are picky and eat only kid fare of burgers, fries and chicken nuggets. Children are less likely to turn up their nose at a new food, however, if it is presented in a small quantity along with some favorite foods. Try it and see!

For both adults and children, the treatment of obesity presents many challenges. Although it takes effort, prevention is far easier. Initiate appropriate lifestyle changes: replace sedentary activities with robust exercise and practice better eating habits; then Johnny WILL be healthier!

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